This application describes a pathway to independence program of mentoring and research for Emi Murano, M.D., Ph.D. The research component of the program is focused on the use of MRI and physiological modeling to help improve the management of glossectomy surgery for the treatment of oral tongue cancer. Oral cancers have the 7th highest incidence in the country; among them, oral tongue cancer has shown a recent 5 to 6-fold increase in incidence in younger adults ages 20 to 44 years and a twofold increase in older adults (Shiboski, 2005). Although the mortality rate of oral tongue cancer is not considered high, its morbidity is significant - causing speech, mastication and swallowing problems, which affect quality of life. The aims of this application are threefold. The first aim is to examine the effects of glossectomy surgery on tongue deformation strategies. These effects will be studied using a unique combination of detailed data on internal tongue deformation from tagged-cine-MRI and anatomy from high-resolution MR images. The data will be compared to speech articulations and acoustics. The clinical goal of this work is to provide objective measurements of tongue function following surgical treatment (partial glossectomy with or without flap reconstruction). The second aim is to use the MRI data from glossectomy patients and normal controls to explore the occurrence of areas of internal rigidity and deformation in the tongue and how they interact with speech motor control. This investigation will be guided by a view of the tongue as a muscular hydrostat and hypotheses about the use of rigidities as a novel way of reducing the complexity of control strategies. The third aim is to simulate glossectomy tongue motion using a physiological/biomechanical model. These simulations, with subject-specific versions of the model, will be used to test our hypotheses, with the ultimate goal of providing a tool for exploring options for surgical management by surgeons, therapists and patients. This work will provide the following new knowledge: (1) Relations between surgical variables and outcomes such as tongue motion and speech quality, (2) Information about patterns of tongue rigidity and how they may constitute a mechanism for reducing the complexity of the motor control of the tongue, (3) Model-based predictions of the effects of muscle resection, flap and scar, including tongue mobility and motion during speech post- surgery. Relevance to public health: This project will lead to increased understanding of the causes of deficits in speech, mastication and swallowing in glossectomy patients. It will also produce unique new data about glossectomy tongue motion as well as insight into normal and compensatory speech motor control. The model will enable surgeons to explore the effects of alternative of surgical strategies on speech, thereby improving the optimization of glossectomy with respect to functional outcomes and rehabilitation. [unreadable] [unreadable] [unreadable] [unreadable]